Can a case lead approach deliver the "craft and graft" of integration?

Purpose: The aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation. Design/methodology/approach: The study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this. Findings: The relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected. Originality/value: The study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments

The Design and Value of "Early Adopter" Low-Energy Houses.

Abstract\ud \ud Purpose. \ud This paper outlines an early adopter “low energy” domestic dwelling, social houses that were built with the collaboration of a University, the local council and the new residents. The origins of this project are from the early days of interest in sustainable housing, the 1970’s. The dwellings were innovative and built to what became known as “the Salford design” which performed to an unusual specification, using about 75% less energy than the UK average for space heating and over 40% less than for houses built to what were then standard building regulations. \ud \ud Design/Methodology/Approach.\ud A qualitative and interpretative stance was deemed to be the most appropriate. Within that lens, interviews were chosen as the primary research instrument. \ud \ud Findings.\ud A marked feature of the results is the variation in energy consumption by different households. A Salford-designed house could be habitable throughout the year without any space heating at all, comfortable at 10%, and very comfortable at 25% of normal consumption.\ud \ud Originality/Value.\ud As there continues to be interest and commitment to reducing energy - not just from the UK but also on a worldwide scale, the United Nations Conference of the Parties known as COP 22 (2016) met in Morocco to take forward many of the initiatives outlined in the Paris Agreement 2015. It is of interest, then, that the latest set of interviews showed that the houses built to the innovative and original 1970’s Salford design principles, protected by a highly insulated, well-sealed envelopes are still today functioning at a relatively low energy threshold

Displaced and vulnerable: A case study of ‘out of area’ housing

This is an accepted manuscript of an article published by Emerald in Housing, Care and Support on 18/09/2020. The published version can be accessed here: https://doi.org/10.1108/HCS-05-2020-0005 The accepted version of the publication may differ from the final published version

Financial viability appraisals for site-specific planning decisions in England

In England, appraisals of the financial viability of development schemes have become an integral part of planning policy-making, initially in determining the amount of planning obligations that might be obtained via legal agreements (known as Section 106 agreements) and latterly as a basis for establishing charging schedules for the Community Infrastructure Levy (CIL). Local planning authorities set these policies on an area-wide basis but ultimately development proposals require consent on a site-by-site basis. It is at this site-specific level that issues of viability are hotly contested. This paper examines case documents, proofs of evidence and decisions from a sample of planning disputes in order to address major issues within development viability, the application of the models and the distribution of the development gain between the developer, landowner and community. The results have specific application to viability assessment in England and should impact on future policy and practice guidance in this field. They also have relevance to other countries that incorporate assessments of economic viability in their planning systems

Can Self-Build Housing improve Social Sustainability within Low-Income Groups?

This paper explores how affordable communal self-build housing affects levels of social cohesion, social capital and participation amongst low-income community members. Thematic analysis of in-depth interviews with members of five low-cost self-build communities in England and Wales elicited that through a shared vision and sustained common sense of purpose, high levels of social capital and participation were evident at the start of the projects, and can continue into later phases. However, without a formal social structure and continued shared visioning within self-build housing communities, social cohesion was found to deteriorate with negative consequences for participation, and in some cases showing a lack of social cohesion or leading to conflict

Multiple factors in the assessment of firesetters' fire interest and attitudes

Purpose: The number of measures available to practitioners to assess fire interest and other fire-related attitudes is limited. To help establish the utility of such measures, this study explored whether three fire measures contained multiple factors and whether such factors related to firesetting behaviour. Method: The Fire Interest Rating Scale, the Fire Attitude Scale, and the Identification with Fire Questionnaire were administered to 234 male prisoners (117 firesetters, 117 non-firesetters) and results were factor analyzed. To determine the relationship of the resulting factors with firesetting behaviour, their ability to discriminate firesetters from controls was examined and compared to the original scales. Results: Responses were best represented by five factors, four of which discriminated firesetters from non-firesetters. One factor demonstrated significant accuracy in discriminating single offence firesetters from repeat firesetters. Taken together the factors offered more clarity than using the original scale outcomes and showed equivalent predictive accuracy. Conclusions: The five factors identified may aid practitioners in helping to formulate the specific treatment needs of identified firesetters

Working with individuals who have experienced homelessness. Stresses and Successes

Purpose Staff who work with vulnerable people with multiple needs are known to experience high levels of stress and burnout, as well as high levels of job satisfaction. This paper explores the experiences of staff working in a project with individuals experiencing long term homelessness in Lincolnshire. Design/methodology/approach An evaluation of a project working with individuals experiencing long term homelessness included a focus group set up to explore the experiences and well being of front line staff and managers. One to one interviews with staff were also held to provide more in depth data about the experiences of individual staff members. Findings Six key themes were identified from the discussions with participants. Decision latitude and the ability to follow service users on person centred journeys over long periods of time were positive aspects of the work which were highly valued and seemed to contribute to high levels of job satisfaction. Things which also made a positive contribution were elements of support provided by the employer and a number of personal coping strategies. Themes identified which had a negative impact on well-being related to high workloads and to the multiple and competing demands from service users and other agencies. Originality/value Few studies of any kind have explored the experiences and wellbeing of staff working in the frontline of homelessness services. This small scale qualitative study provides a number of suggestions for further research with this population. Findings cannot be generalised but match those of other recent studies which suggest high levels of stress but little evidence of burnout, and that carefully developed workplace support mechanisms play a key role in maintaining commitment to the role and preventing burnout

Delivering alcohol identification and brief advice (IBA) in housing settings: a step too far or opening doors?

Within the UK, there is a drive to encourage the delivery of alcohol screening (or identification) and brief advice (IBA) in a range of contexts beyond primary care and hospitals where the evidence is strongest. However, the evidence base for effectiveness in non-health contexts is not currently established. This paper considers the case of housing provided by social landlords, drawing on two research studies which were conducted concurrently. One study examined the feasibility of delivering alcohol IBA in housing settings and the other the role of training in delivering IBA in non-health contexts including housing. This paper draws mainly on the qualitative data collected for both studies to examine the appropriateness and feasibility of delivering IBA in a range of social housing settings by the housing workforce. Findings suggest that while it is feasible to deliver IBA in housing settings, there are similar challenges and barriers to those already identified in relation to primary care. These include issues around role inadequacy, role legitimacy and the lack of support to work with people with alcohol problems. Results indicate that the potential may lie in focusing training efforts on specific roles to deliver IBA rather than it being expected of all staff